Aplicaciones y proyecciones de los antagonistas del receptor de mineralocorticoides en el tratamiento de patologías cardiovasculares

Verdugo, Fernando; Montellano, Felipe A.; Carreño, Juan; Marusic, Elisa T.

doi:10.4067/s0034-98872014000100010

Cited by 3 publications

(2 citation statements)

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“…La aldosterona afecta principalmente el componente cardiaco y renal, estimulando por medio del receptor de mineralocorticoides las vías moleculares que llevan a la activación de ERK1/2 y PI3K/AKT/mTOR (6) y PDGFR, PI3K y MAPK (3). A través de estas vías, a nivel renal se da una lesión a nivel de los podocitos, afectando así la membrana de filtración glomerular y adicionalmente existe un compromiso en células mesangiales con la consiguiente hiperplasia mesangial, que va a conducir finalmente a la respuesta inflamatoria, apoptosis y recambio celular a fibroblastos para aumentar fibrosis, afectando directamente el riñón, pero indirectamente también va a existir una afección cardiaca (3,12). A nivel cardiaco se ha visto que el cortisol, a través de su acción en el receptor de mineralocorticoides, afecta la diferenciación y la organización de los cardiomiocitos, causando así el compromiso cardiaco directamente.…”

Section: Introducción a Antagonistas Del Receptor Mineralocorticoideunclassified

Acción de la aldosterona y el receptor de mineralocorticoides en insuficiencia renal crónica y falla cardiaca

Amézquita

Páez

Tovar

et al. 2023

Rev.ACE

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Contexto: el papel de la aldosterona y el de su receptor son motivos de investigación y aprendizaje continuo por su impacto en condiciones patológicas, en especial cardiacas y renales. Objetivo: realizar una revisión narrativa acerca del efecto renal y cardiaco de la aldosterona junto a su receptor y describir la evidencia disponible en estudios clínicos de los medicamentos que tienen como objetivo terapéutico. Metodología: para responder a las preguntas: ¿cuáles son los efectos cardiacos y renales de la activación del receptor de aldosterona en condiciones patológicas? y ¿qué estrategias terapéuticas implementadas se han utilizado en estudios aleatorizados? Se realizó una búsqueda en la base de datos Pubmed con las palabras clave y los términos Mesh relacionados. Resultados: esta revisión presenta una gran variedad de mecanismos de acción alternativos de la aldosterona y el receptor de mineralocorticoides y su relación con respecto a otros receptores, marcando su acción genómica y no genómica, que llevan finalmente a promover la inflamación y la fibrosis a nivel cardiaco y renal. Por último, se realiza un resumen de los estudios fase II y III de antagonistas de la aldosterona. Conclusiones: la aldosterona es una hormona de gran relevancia por su acción en el riñón y el corazón desde su desarrollo y el receptor de mineralocorticoides se revela como un objetivo terapéutico, en el que los medicamentos mejorados se destacan por ser más específicos y por tener menos efectos adversos.

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Section: Introducción a Antagonistas Del Receptor Mineralocorticoideunclassified

Acción de la aldosterona y el receptor de mineralocorticoides en insuficiencia renal crónica y falla cardiaca

Amézquita

Páez

Tovar

et al. 2023

Rev.ACE

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“…Most of aldosterone’s pathophysiological effects have a course of several weeks and therefore, are most likely dependent on mineralocorticoid receptors. However, some inflammatory markers (tumor necrosis factor and ED-1) and collagen III deposition increases have been observed in some models of fibrosis induced by mineralocorticoids [ 6 - 9 ].…”

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confidence: 99%

Production of aldosterone in cardiac tissues of healthy dogs and with dilated myocardiopathy

et al. 2017

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Background and Aim:Aldosterone is a hormone, belonging to the group of mineralocorticoids, mainly synthesized in the adrenal cortex, basically its function is to regulate blood pressure and sodium-potassium levels in the body; high levels of this hormone have harmful effects in the organism and mainly in the heart in chronic form. Dilated cardiomyopathy is a progressive disease of heart muscle that is characterized by ventricular chamber enlargement and contractile dysfunction, is one of the most common cardiac conditions in dogs of medium and large breeds. The aim of the study was to determine and quantify if a dog’s cardiac cells possess the capacity to synthesize aldosterone, as well as, the differences that appear between a healthy heart and with dilated myocardiopathy (DMC).Materials and Methods:Cardiac tissues were used from six healthy dogs and six with DMC. Enzyme-linked immunosorbent assay was performed to determine if the dog’s heart cells synthesized this mineralocorticoid in a similar way to rat, rabbit, and human tissues, as well as quantitative differences between the healthy heart and DMC.Results:In healthy dog hearts, aldosterone values were 62.5 pG for both the atria and right ventricle and 125 pG for the left ventricle. As for dog hearts’ with DMC, results were 125 pG in all four cavities.Conclusion:Both the healthy and DMC dog hearts produce aldosterone in all four cavities, observing that production increases in the atria and right ventricle of those hearts with DMC, as an intrinsic mechanism of cardiac remodeling.

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Cancer Antigen 125 is Associated with Length of Stay in Patients with Acute Heart Failure

Kaya¹,

Kurt²,

Beton³

et al. 2017

Texas Heart Institute Journal

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Length of stay is the primary driver of heart-failure hospitalization costs. Because cancer antigen 125 has been associated with poor morbidity and mortality rates in heart failure, we investigated the relationship between admission cancer antigen 125 levels and lengths of stay in heart-failure patients. A total of 267 consecutive patients (184 men, 83 women) with acute decompensated heart failure were evaluated prospectively. The median length of stay was 4 days, and the patients were classified into 2 groups: those with lengths of stay ≤4 days and those with lengths of stay >4 days. Patients with longer lengths of stay had a significantly higher cancer antigen 125 level of 114 U/mL (range, 9–298 U/mL) than did those with a shorter length of stay (19 U/mL; range; 3–68) (P <0.001). The optimal cutoff level of cancer antigen 125 in the prediction of length of stay was >48 U/mL, with a specificity of 95.8% and a sensitivity of 96% (area under the curve, 0.979; 95% confidence interval [CI], 0.953–0.992). In the multivariate logistic regression model, cancer antigen 125 >48 U/mL on admission (odds ratio=4.562; 95% CI, 1.826–11.398; P=0.001), sodium level (P<0.001), creatinine level (P=0.009), and atrial fibrillation (P=0.015) were also associated with a longer length of stay after adjustment for variables found to be statistically significant in univariate analysis and correlated with cancer antigen 125 level. In addition, it appears that in a cohort of patients with acute decompensated heart failure, cancer antigen 125 is independently associated with prolonged length of stay.

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Aplicaciones y proyecciones de los antagonistas del receptor de mineralocorticoides en el tratamiento de patologías cardiovasculares

Abstract: In recent years, much attention has focused on the role of aldosterone and mineralocorticoid receptors (MRs) education, monitoring, and follow-up. (Rev Med Chile 2014; 142: 61-71)

Cited by 3 publications

References 68 publications

Acción de la aldosterona y el receptor de mineralocorticoides en insuficiencia renal crónica y falla cardiaca

Acción de la aldosterona y el receptor de mineralocorticoides en insuficiencia renal crónica y falla cardiaca

Production of aldosterone in cardiac tissues of healthy dogs and with dilated myocardiopathy

Cancer Antigen 125 is Associated with Length of Stay in Patients with Acute Heart Failure

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